Pittsburgh n'@

New Year's Day featured a Post-Gazette story on Ken Melani's "circuitous journey from Allegheny Valley to Highmark," one of those Horatio Alger tales about a local boy who made a lot of money. By all accounts, Melani's forebears were like most people in the Allegheny Valley in that they actually worked for a living.

Bill Toland's Post-Gazette account [notes] Melani's birthplace of New Kensington was "a robust town of pool halls and numbers games." That it was, and much more, because "New Ken" was the preserve of one Gabriel "Kelly" Mannarino. Mannarino was an exemplar of the old saying that "Teach a man to fish, and he will eat for a day; teach a man that he'd better watch out or he'll be sleeping with the fishes, and he will pay back your money first thing Monday morning, signore, I promise, please, just give me a few more days." Indeed, Kelly Mannarino rose from his humble origins to second-in-command of Pittsburgh's La Cosa Nostra.

[But] next to Ken Melani, Kelly Mannarino was a rank amateur. Melani's Highmark steals more from the mouths of sick people in the space of a week than Kelly Mannarino stole from down-on-their-luck gamblers in his entire lifetime. The road from the Black Hand to the blue "greater hand in your health" is paved with the billions of dollars in "reserves" that Melani used not to lower premiums or cover the uninsured -- let alone to pay claims -- but to launch a competitive drive against Capital Blue Cross and Independence Blue Cross in the other half of the state. [W]hen the merger with Independence is approved by regulators -- as it almost certainly will be -- he will be capo di tutti capi of the health insurance rackets.